Oncology Nurse Consultant - Registered Nurse

We’re building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Are you an experienced Oncology Nurse looking for an opportunity to make a meaningful impact throughout a patient's cancer journey? Join our innovative Oncology Care Model team and serve as a clinical leader, care coordinator, and utilization management expert, helping members navigate treatment, access appropriate care, and achieve the best possible outcomes.

Oncology Nurse Consultant serves as a hybrid Care Management and Utilization Management professional, providing comprehensive support to oncology members from diagnosis through treatment and recovery. As part of an interdisciplinary team that includes a Medical Director, Nurse Practitioner, Pharmacist, Behavioral Health Specialist, and Oncology Companion , you will work collaboratively to ensure members receive evidence-based, coordinated, and cost-effective oncology care.

• Clinical Case Management Conduct comprehensive clinical assessments and identify members who would benefit from oncology case management services
  
  Develop, implement, and monitor individualized care management plans
  
  Assess medical, psychosocial, functional, and support needs throughout the cancer journey
  
  Advocate for members to maximize available healthcare benefits and services
  
  Support transitions of care, discharge planning, and ongoing treatment coordination
  
  Identify and escalate quality-of-care concerns through established channels
• Oncology Care Coordination Serve as a trusted clinical resource for members and caregivers throughout treatment
  
  Coordinate care with oncologists, specialists, hospitals, providers, and community resources
  
  Evaluate members' health literacy, readiness for change, and support needs
  
  Provide education, coaching, and ongoing support to help members make informed healthcare decisions
  
  Utilize motivational interviewing techniques to improve engagement and treatment adherence
• Utilization Management Perform utilization reviews and evaluate medical necessity for oncology-related services
  
  Apply evidence-based oncology guidelines and clinical criteria to support treatment decisions
  
  Leverage NCCN guidelines to assess treatment plans and support adherence to best practices
  
  Partner with Medical Directors and treating providers to review treatment exceptions and clinical variances
  
  Review medical records and clinical documentation to ensure appropriate utilization of healthcare resources
  
  Support cost-effective treatment recommendations while maintaining quality patient outcomes
• Collaboration & Program Development Participate actively in multidisciplinary oncology team discussions
  
  Consult with providers, internal stakeholders, and healthcare partners regarding utilization management and care planning
  
  Contribute ideas and recommendations to improve program effectiveness and member experience
  
  Support organizational goals focused on quality, outcomes, and healthcare resource optimization

• Active, unrestricted RN license in state of residence
  
  Ability to obtain multi-state licensure upon hire Current Oncology Nursing Certification Corporation (ONCC) certification, including one of the following: OCNCPHONCBCNTCTCNAOCNPROCNTMAOCNSAOCN
• 5+ years of oncology nursing experience2+ years of Utilization Management experience
  
  Knowledge of:
  Oncology treatment protocols
  
  Cancer symptom management
  
  Supportive…